FANZCA Assessment and Evaluation 4

Question 1

Which test is used to evaluate neuromuscular blockade recovery and specifically assesses fade at the laryngeal adductors?

Accepted Answer

Acceleromyography at the corrugator supercilii

Answer

The corrugator supercilii muscle has similar pharmacodynamic sensitivity to the laryngeal adductors, making acceleromyography at this site a better surrogate for airway muscle recovery than the adductor pollicis.

Question 2

A parturient at 38 weeks is assessed before elective Caesarean section. Which laboratory test result would prompt anaesthetic concern regarding neuraxial technique?

Accepted Answer

Platelet count 68 × 10⁹/L

Answer

A platelet count below 80 × 10⁹/L is generally considered a relative contraindication to neuraxial anaesthesia due to increased risk of spinal haematoma.

Question 3

In a patient with suspected increased intracranial pressure (ICP), which clinical sign represents Cushing's triad?

Accepted Answer

Hypertension, bradycardia, and irregular respirations

Answer

Cushing's triad (hypertension, bradycardia, irregular respirations) is a late and ominous sign of critically raised ICP and impending brainstem herniation.

Question 4

Which finding on cardiopulmonary exercise testing (CPET) best stratifies perioperative mortality risk for major abdominal surgery?

Accepted Answer

Anaerobic threshold (AT) < 11 mL/kg/min

Answer

An anaerobic threshold below 11 mL/kg/min on CPET is a validated predictor of increased perioperative morbidity and mortality for major surgery.

Question 5

A patient scheduled for total knee replacement is taking dabigatran 150 mg twice daily. According to bridging guidelines for normal renal function, when should the last dose be taken preoperatively for high bleeding-risk surgery?

Accepted Answer

48–72 hours before surgery

Answer

For high bleeding-risk surgery with normal renal function (CrCl >50 mL/min), dabigatran should be stopped 48–72 hours (2–3 days) before the procedure.

(FANZCA) Fellowship of the Australian and New Zealand College of Anaesthetists Practice Test

(FANZCA) Fellowship of the Australian and New Zealand College of Anaesthetists Practice Test

FANZCA Assessment and Evaluation 4